Case Report

All-trans Retinoic Acid Syndrome: Another Cause of Drug-induced Respiratory Failure

Authors: Zubair Ahmed, MD, Mohammed A. Shaikh, MD, Abhijit Raval, MD, Jay B. Mehta, MD, Ryland P. Byrd, Jr MD, Thomas M. Roy, MD

Abstract

It is now possible to achieve complete remission in the majority of patients with acute promyelocytic leukemia (APL) if all-trans retinoic acid (ATRA) is administered as a single agent or in combination with cytotoxic chemotherapy. Despite its positive influence on recovery, ATRA is not without the potential for toxicity. It is important for clinicians participating in the care of patients undergoing treatment with this drug to be aware of ATRA syndrome and institute the appropriate therapy to reduce the likelihood of an adverse outcome.


Key Points


* Modern chemotherapeutic treatment can result in complete remission in most patients with acute promyelocytic leukemia.


* All-trans retinoic acid (ATRA) is an important component in the therapy of acute promyelocytic leukemia.


* ATRA is not without toxicity, the most important of which is ATRA syndrome.


* Early recognition and treatment of ATRA syndrome can reduce the morbidity and mortality associated with this disorder.

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